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2103 Milling Rd DAVIE COUNTY; HEALTH DEPARTMENT �,.(�U 11 30 IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION 'NOTE: Issued in Compliance with G.S. of North Carolina Chapter 130 Article 13c Sewage Treatment and Disposal Rules (10 NCAC 10A .1934-.1968) Permit Number Name 6 V V A R, �`' �, �'� Q � Date � - � - � 9 N2 5671 Location Subdivision Name Lot No. Sec. or Block No. Lot Size . RR Q� House Mobile Home _ Business Speculation No. Bedrooms _ No. Baths No. in Family Garbage Disposal YES .2' NO ❑ Specifications for System: Z -R� Auto Dish Washer" YES ©" NO 0 r 6� � x ., � x , �� Auto Wash Machine YES g/NO C] Type Water Supply w 'This permit Void if sewage system described below is not installed within 36 months from date of issue. b it E yr. . y Improvements permit by \- �,*�, 'Contact a representative of the Davie County Healthy Department for final inspection of this system between 8:30- 9.:30 A.M. or 1:00-1:30 P.M. on day of completion. Telephone Number: 704-634-5985. Final Installation Diagram: System,Installed by h � U Certificate of Completion �' Date 'The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. . ,.."3 ��r.. .v'i.,;..ra�k .'j.f."-moi..-.qC Nety h.i `v,:�i-v,l'T��•..-r 0,a.;i'-.E. -„ -.._ .., t`> � Y,..Y:t„ ,`-�'s,..du ..e s '-s.-`^-,+"_5+.•"' •,1 •• .. 102.�'wv'� ,. • - .r DAVIE CdNTY, HEALTH DEPARTMENT IMPROVEMENTS PERMIT AND CERTIFICATE OF COMPLETION *NOTE .Issu4d in Compliance with G.S. of North Carolina Chapter 130 Article 13c Sew ge Treatment and Disposal Rules (10 NCAC 1.OA .1934-.1968) Perrhit Number -Name S5'N "L� d �.~ � _ j_`� Date — ' N2 56711 Location 'r Subdivision Name Lot No. Sec. or Block No. Lot Size Z (Lzn,4, House Mobile Home _ Business Speculation No. Bedroomi-L.2 No. Baths No. in Family y ' Garbage Disposal YES ga/ N0 p Specifications for System: 3 o't Auto Dish Washer YES 2-' NO C3 0 n N X � % x 1 \% Auto Wash Machine YES p/NO C] Type Water Supply A,% *This permit Void if sewage system described below is not installed within 36 months from date of issue. T w 7 Improvements permit by *Contact a representative of the Davie County Healthr Department for final inspection of this system between 8:30- 9:30 A.M. or 1:00-1:30 P.M. on day, of completion. Telephone Number: 704-634-5985. Final Installation Diagram: System Installed by 1 U a 11 11 Certificate of Completion Date *The signing of this certificate shall indicate that the system described above has been installed in compliance with the standards set forth in the above regulation, but shall in NO way be taken as a guarantee that the system will function satisfactorily for any given period of time. INFORMATION FOR SEPTIC SYSTEM REPAIR PERMIT b, / q NAME a 1 R PHONE NUMBER ADDRESS SUBDIVISION NAME SUBDIVISION LOT• 0 DIRECTIONS TO SITE f DATE SEPTIC SYSTEM INSTALLED NAME SEPTIC SYSTEM ORIGINALLY INSTALLED UNDER SPECIFY PROBLEMS THAT ARE OCCURRING DATE REQUESTED Z '�j ��cj INFORMATION TAKEN BY � ��